Log in with your email address username.


Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

Gestational diabetes needs to be managed

- Featured Image

In reply: Taylor welcomes a strong evidence base for clinical practice, which is echoed by d’Emden and colleagues. However, their strong support for the current Australian diagnostic criteria for gestational diabetes mellitus (GDM) is surprising, given that these criteria are the product of an “Ad Hoc Working Party” report.1 This guideline, published in 1991, clearly acknowledged a lack of strong evidence and advocated criteria that were based on best available rounded values for the 95th centile of venous plasma glucose (VPG) levels in the fasting state (5.5 mmol/L) and 2 hours after a 75 g glucose load (8.0 mmol/L) — values that had been published in an unreferenced overview of Australian and European data.1 It advocated future prospective studies, such as those which form the basis of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recommendations.2 Contrary to d’Emden et al’s assertions, the 1991 fasting and 2-hour VPG level cut-offs are misaligned. Contemporary data from the 2120 Australian women in the Hyperglycemia and Adverse Pregnancy Outcome study, using the 75 g oral glucose tolerance test, show that 5.5 mmol/L lies at the 98th centile…